Abstract
Background Nodular fasciitis is a benign neoplasm occurring predominantly in the subcutaneous
tissue. There have been nine intraneural occurrences described in the literature.
Case report A 37-year-old woman presented with numbness and tenderness in her left shoulder and
scapula and a slightly dropped left shoulder, without history of trauma. A magnetic
resonance imaging (MRI) of the cervical spine showed a well-circumscribed oval mass
deep to the levator scapula muscle. Due to persisting symptoms and an unknown nature
of the process, surgical excision was performed, and histopathologic analysis confirmed
diagnosis of a benign fibroblastic/myofibroblastic neoplasm, nodular fasciitis. The
postoperative course was uneventful and the patient was without symptoms at 4 months
of follow-up.
Methods We reviewed the available literature (PubMed, Google Scholar), with nine published
cases of intraneural nodular fasciitis. The reported clinical, radiologic, and histopathologic
parameters were evaluated and compared.
Discussion Most of the cases reported in the literature were symptomatic, with tenderness and
palpability being the main symptoms. Six of the reported cases occurred in the forearm,
whereas three were in the leg. To the best of our knowledge, ours is the first reported
case of nodular fasciitis occurring in the trunk. Ours is the only case to display
desmin positivity, which supports the reactive hypothesis of nodular fasciitis.
Conclusion Intraneural nodular fasciitis is an extremely rare diagnosis. Due to its benign natural
course, a multidisciplinary approach with this extremely rare diagnosis in mind is
needed to avoid overtreatment.
Keywords
nodular fasciitis - dorsal scapular nerve - peripheral nerve tumors - intraneural
nodular fasciitis
